phone 1-877-medplan
Assurant Short-Term Application - Indiana
Option A
Download Paper Application Form
pdf - 63KB
Download and Print the Assurant Health Short-Term Medical Insurance paper application form. Complete it by hand and mail it in (instructions included).
Option B
Send Application via Email or Regular Mail
Instruct us how and where you want us to send you the Assurant Health Short-Term Medical Insurance application form.
